The Doctor Will Video Chat With You Now: Insurer Covers Virtual Visits
If you can live stream movies, why not live stream medical care?
Insurance company UnitedHealthcare will start covering visits to the doctor's office — via video chat. Patients and physicians talk live online — on smartphones, tablets or home computer — to get to a clinical diagnosis. This move to cybermedicine could save insurers a ton of money — or have unintended consequences.
Cybermedicine has been long-discussed by the experts. Now, Eric Neiman, father to a little girl in San Francisco, can explain how it works — from personal experience.
"So I'd gotten a text from my wife earlier in the day," he says. "One of our daughter's eyes was a little bit red and she was rubbing it."
A few hours passed and it got more red and started oozing. "Well, unfortunately that sounds like it could be pinkeye. So we would look at it together when I got home," Neiman says.
Which was close to 8 p.m. — too late to see their regular pediatrician. And kind of late to see any doctor. If they went to the local urgent care center, they'd get back home at 10 p.m. or 11 p.m.
Then, Neiman remembered something, from his Instagram account, a post for an app called Doctor On Demand. It pairs users up with doctors who are licensed in their state for a video screening.
Neiman decided to log in. "The pediatrician came on, introduced himself, and then asked to see our daughter, asked to hold the iPhone up to her eye, checked her throat, everything that he could see via the phone."
Within minutes, the doctor called in a prescription for pinkeye. The visit cost Neiman $40.
Neiman was so impressed, he says, he used the app just a few days later for himself. He thought he was getting a sinus infection, and logged in from his car.
"I was sitting on the side of the street. It's not the first time I pulled over to use my phone," he says. "But to actually go to the doctor — I was just hopeful nobody was watching!"
Save On Cost Or Break The Bank?
UnitedHealthcare's move to cover all or part of the cost of these e-visits — for up to 20 million customers by 2016 — is big. A major company is putting its stamp of approval on a process that, until now, has been largely experimental.
Three mobile-doc startups – Doctor on Demand, NowClinic and Amwell – are the initial providers.
Karen Scott, who directs innovation initiatives at UnitedHealthcare, says the company is studying cost: "What happens if somebody is more likely to use virtual care? Maybe they would have gone in to urgent care. How many of them will choose the virtual visit instead?"
It could be that people grab a doctor online for skin rashes, colds and coughs — and by getting care early on, they prevent an expensive catastrophe. Or maybe people wait too long when they really just need to see a doctor in person. Or it could be this service brings out the inner hypochondriac in us and leaves the insurer with a bigger bill to co-pay.
"Those are the sorts of health care economics and actuarial questions that our experts will be watching," Scott says.
Convenience For Doctors
This move has big implications for physicians, too.
Dr. Tania Elliott, an allergist with Doctor on Demand, says that through the app, patients with a rash show her their symptoms in the moment — not a week later. She takes virtual tours of people's homes to search dust mite sources. Instead of tedious planning, she gives patients a ballpark of when to do a follow up visit.
"They have access to essentially my schedule. And so when they log into the app they can see when I'm online," she says.
The doctor has even gotten to work remotely — from a hotel room in Hawaii.
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Transcript
ROBERT SIEGEL, HOST:
There's big news in health care today involving video chats. The insurance company United Healthcare has announced that it's going to start covering virtual visits to the doctor's office. Patients and physicians will talk live, but on smart phones. NPR's Aarti Shahani reports that this move towards cyber medicine could save insurers a ton of money or introduce new problems.
AARTI SHAHANI, BYLINE: Here's how cyber medicine works.
ERIC NEIMAN: So I had gotten a text from my wife earlier in the day.
SHAHANI: Eric Neiman, father of a little girl in San Francisco, explains.
NEIMAN: Our daughter's eyes was a little bit red, and she was rubbing it.
SHAHANI: A few hours passed, and it got more red, oozing something.
NEIMAN: And I said, well, unfortunately, that sounds like it could be pink eye, so we would look at it together when I get home.
SHAHANI: Which was close to 8 p.m. - too late to see their regular pediatrician. And if they went to the local urgent care center, they'd get back 10, maybe 11. Then Neiman remembered something.
NEIMAN: Seeing an Instagram post...
SHAHANI: ...From an app called Doctor On Demand. It pairs users up with doctors who are licensed in their state to do a video screening. Neiman decided to log in.
NEIMAN: The pediatrician came on, introduced himself, asked to see our daughter, asked to hold the iPhone up to her eye, checked her throat, everything that he could see via the phone.
SHAHANI: Within minutes, the doctor called in a prescription for pinkeye. The visit cost $40. Neiman was so impressed, he says, he used the app just a few days later for himself. He thought he was getting a sinus infection and logged in from his car, which is kind of weird.
NEIMAN: No - yeah 'cause I'm sitting on the side of the street, you know, and I'm like - it's not the first time I've pulled over to use my phone, but to actually, you know, go to the doctor - I was just hopeful nobody was watching. (Laughter).
SHAHANI: United Healthcare's move to cover all or part of these e-visits for up to 20 million customers by next year - that's big. A major company is putting its stamp of approval on a process that till now has been experimental - for the adventurous Instagram type. Three mobile doc startups - Doctor On Demand, NowClinic and Amwell - are the initial providers. Karen Scott, who directs innovation initiatives at United Healthcare, says they're keeping an eye on cost.
KAREN SCOTT: What happens if somebody is more likely to use virtual care?
SHAHANI: It could be that people grab a doctor online for skin rashes, colds and coughs, and by getting care early on, they prevent an expensive catastrophe. It could be they wait too long when they really need a doctor in person. Or it could be the service brings out the inner hypochondriac in us and leaves the insurer with a bigger bill to co-pay.
SCOTT: Those are the sorts of health care economics and actuarial questions that our experts will be watching, you know, as this fully ramps.
SHAHANI: This move impacts physicians, too. Doctor Tania Elliot, an allergist with Doctor On Demand, says through the app patients with a rash show her in the moment, not a week later. She takes tours of people's homes to search the source of dust mites. Instead of planning a follow-up visit, she gives patients a ballpark of when to call.
TANIA ELLIOT: They have access to, essentially, my schedule. And so when they log in to the app, they can see when I'm online.
SHAHANI: The doctor has even gotten to work remotely from a hotel room in Maui. Aarti Shahani, NPR News, San Francisco. Transcript provided by NPR, Copyright NPR.
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